Provider Demographics
NPI:1053596163
Name:MONTANYE & ASSOCIATES
Entity type:Organization
Organization Name:MONTANYE & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LARUE
Authorized Official - Middle Name:R
Authorized Official - Last Name:MONTANYE
Authorized Official - Suffix:
Authorized Official - Credentials:DED
Authorized Official - Phone:570-368-2624
Mailing Address - Street 1:355 BROAD ST
Mailing Address - Street 2:P.O. BOX 125
Mailing Address - City:MONTOURSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17754-2221
Mailing Address - Country:US
Mailing Address - Phone:570-368-2624
Mailing Address - Fax:570-368-2212
Practice Address - Street 1:355 BROAD ST
Practice Address - Street 2:
Practice Address - City:MONTOURSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17754-2221
Practice Address - Country:US
Practice Address - Phone:570-368-2624
Practice Address - Fax:570-368-2212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS002406L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty